Individual provider Active NPI

Marla Jolene Canda, MOT, OTR/L

  • Occupational Therapist
  • Lake Forest, IL
National Provider Identifier
1700773652
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.016517 Issued in IL
Practice address
1200 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1601
Phone
(847) 535-6866
NPI assigned
Jun 23, 2025
Last updated
Jun 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.016517 IL Primary

Addresses

Primary practice location

1200 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1601

Mailing address

1200 N Westmoreland Rd Ste 100
Lake Forest, IL 60045-1601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056.016517ILMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1750636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1700773652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WESTMORELAND RD STE 100",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451601",
            "telephone_number": "847-535-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDA",
        "first_name": "MARLA",
        "middle_name": "JOLENE",
        "credential": "MOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-23",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.016517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.